Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
facility
Low
$0
Average
$11
Median
$5
High
$138
Each hospital's average Optum rate, under the methodology and billing class chosen below.
40 hospitals; the 90th percentile is 26.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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44 hospital rates
iThe hospitals that file a Optum rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 2 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $138 | $250 | 181% | — | $11 – $639 |
| 3 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · outpatient | 3 | $1 | $5 | $8 | 175% | — | $0 – $33 |
| 4 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 8 | Connecticut Children's Hartford, CT percent of total billed charges · inpatientfrom % of charges | 3 | $2 | $4 | $5 | 110% | — | $0 – $13 |
| 9 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $7 | $49 | $72 | 146% | — | $2 – $189 |
| 10 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 11 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 12 | HCA FLORIDA LARGO HOSPITAL CLEARWATER, FL percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | $0 | 4% | — | $9 – $9 |
| 13 | Holy Name Teaneck, NJ facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 16 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 17 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 18 | MEDICAL CITY DALLAS GARLAND, TX percent of total billed charges · outpatientfrom % of charges | 2 | $1 | $1 | $1 | 78% | — | $0 – $2 |
| 19 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 20 | METHODIST HOSPITAL HELOTES, TX percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | $3 | 8% | — | $28 – $33 |
| 21 | METHODIST SPECIALTY AND TRANSPLANT SAN ANTONIO, TX percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | $3 | 8% | — | $28 – $33 |
| 22 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · other · outpatient | 1 | $2 | $2 | $0 | 22% | — | $1 – $2 |
| 24 | RESEARCH MEDICAL CENTER KANSAS CITY, MO percent of total billed charges · outpatientfrom % of charges | 2 | $1 | $1 | $0 | 15% | — | $1 – $1 |
| 25 | ST LUKE'S LAKESIDE HOSPITAL, LLC The Woodlands, TX fee schedule · outpatient | 3 | $1 | $5 | $8 | 175% | — | $0 – $33 |
← Payers reporting HCPCS Q0169 · Snapshot 20261111T120946Z-9134e7f7